One Brain's journey

Once again a study, this time at Duke University in Durham, North Carolina, examined role of working memory, and some other cognitive functions, in the development of schizophrenia. This time they were studying the pattern of cognitive disorders schizophrenics exhibit as children long before they have symptoms of schizophrenia. Duke researchers drew on the results of a long-term study conducted in New Zealand with more than 1,000 participants and found a consistent pattern of developmental difficulties starting at age seven. Co-author of the study, Richard Keefe, director of Duke’s Schizophrenia Research Group said, “These kids are lagging behind to begin with and they continue to fall behind.”

There were two patterns emerging:

1. Children who later developed schizophrenia had early deficits in verbal and visual learning, reasoning and conceptualization and these remained as they grew older

2. They also developed more slowly than their peers in processing speed, attention, visual-spatial problem solving and working memory

How all this ends up as schizophrenia is still unknown but another co-author in the study, Avshalom Caspi, who is the Edward M. Arnett Professor of Psychiatry at Duke, speculates that a child who struggles to make sense of the world becomes more socially isolated or more delusional.

Keefe said that eventually he hoped that they might be able to intervene, perhaps with anti-psychotic medication, in childhood and head off the adult psychosis. The study suggests that adult psychosis doesn’t just emerge fully formed but has early roots in the developmental process.

I have thought for a long time that schizophrenia is one of the saddest disorders as it seems as if one’s mind turns against oneself but there is another disorder that it is even sadder where one’s mind does something quite similar. That disorder is Obsessive Compulsive Disorder (OCD). One of the required symptoms for a diagnosis of OCD is that the person must be conscious of their obsessive or compulsive behavior but be helpless to do anything about it. I know at least one person who has OCD and my heart goes out to her. Many times when she is exhibiting symptoms, she is in tears. I have, for a brief time in the past, had OCD symptoms and so have some understanding of how this plays out. In my case the behavior was checking and it was like I had forgotten whether I had locked a door again and again and again. I had, as a child, seen my father do this (so maybe it’s a family trait) and at the time a part of me marveled at the fact that I was repeating this simple action so many times. In my case it passed and has not returned. It happened at a time of great stress so I do have a worry that it could, at some point, return but the person that I was describing earlier has it most of the time and spends much of that time locked in her apartment because it is so painful for her to go outside. Her behavior is also checking but it involves looking at every scrap of paper she comes across to see if one of her friends or family has left her a personal message. A mutual friend who was trying to help her by walking with her one time asked her, “Do you really think that a friend would leave a note for you on the street in the gutter.” The friend with OCD just looked down and cried.

I am so glad that my own symptoms were so short lived but I also hope that this new study will lead to the possibility of earlier intervention and perhaps head of the disorder–at least for schizophrenia.

Working memory was first explained to me by a psychologist friend as memory in which words, numbers or visual images and spatial relationships are stored for just a few seconds to be manipulated or recalled. I know from an neuro-psychological assessment I had in 2004 that I have a problem as described in the report as “Immediate and delayed recall of visual and non-verbal information.”

I was also tested in these three key areas by Dr. Atilla Turgay during a consultation in his office last summer. He does this test in just a few minutes asking you to remember and repeat back seven digit numbers, sentences forward and backward and then, the one I did terribly at, the positioning of his fingers, hands and legs which I had to replicate.

Lately I have come across references to working memory as fluid intelligence and the I started to get confused. This confusion increased just a few weeks ago when I was reading a blog that referred to a relationship between schizophrenia and problems in working memory. It would seem this is getting pretty far from remembering someone’s phone number or a street address. I accept that my knowledge in this area is limited. In addition, new knowledge in the area of neuroscience seems to be increasing daily.

I will come back to this subject when my own understanding has grown enough to explore it further…